The health of college students on the autism spectrum as compared to their neurotypical peers

Abstract

Data from an online survey of undergraduate students at 14 colleges and universities were used to estimate the association of autism with six physical and mental health outcomes, accounting for comorbidity with other disabilities (learning disability, attention deficit hyperactivity disorder, sensory impairment, mobility impairment, mental health disorder, or other disabilities). Autism status was determined based on registration for disability accommodations based on autism and/or self-reports of an autism diagnosis. Health outcomes included self-rated physical health, self-rated mental health, depressive symptoms, symptoms of anxiety, sleep deprivation, and binge drinking. Students with autism reported poorer self-rated physical and mental health, more depressive symptoms, and more symptoms of anxiety than other students, even in the presence of controls for other disabilities. Students with autism also reported a lower likelihood of sleep deprivation and binge drinking than other students. Our results extend previous research on the health correlates of autism by considering additional indicators of health and by incorporating a direct comparison to neurotypical students. They encourage consideration of how health services for students with autism can be improved, especially for mental health problems, and argue for integrated support services that address the full constellation of physical and mental health challenges that students on the spectrum experience. Lay abstract Studies have shown that children and older adults on the autism spectrum experience more physical and mental health problems than their neurotypical peers. Less is known about the physical and mental health of college students on the spectrum. Studying college students is important because young adults on the spectrum are enrolling in college at increasing rates and because health problems can be a barrier to succeeding in college. We collected data from 2820 students at 14 colleges and universities using an online survey, some of whom had registered for accommodations based on autism and others of whom had not. We used the data to compare the physical and mental health of students on the spectrum to their neurotypical peers. Because students with autism often report other disabilities that also affect health, we accounted for whether they experienced a learning disability, attention deficit hyperactivity disorder, sensory impairment, mobility impairment, mental health disorder, or any other disabilities. We assessed health using self-reports of how healthy they were physically and mentally, and reports of depressive symptoms, symptoms of anxiety, sleep deprivation, and binge drinking. We found that students with autism reported poorer physical and mental health, more depressive symptoms, and more symptoms of anxiety even after taking into account other disabilities they may have experienced. They were also less likely to report sleep deprivation and binge drinking. Our results argue for developing specialized services to address the physical and mental health challenges of college students on the spectrum.

Understanding the substance use of autistic adolescents and adults: a mixed-methods approach

“…Several studies taken from both clinical and general population samples (with sample sizes ranging from 89 to 4123 autistic participants) suggest that autistic individuals are less likely to smoke, use tobacco, use nicotine, 11 , 12 , 13 or misuse substances (including alcohol) than non-autistic individuals. 12 , 13 , 14 , 15 , 16 By contrast, results from larger studies and one systematic review indicate that autistic individuals might have an increased likelihood of developing substance use-related problems. 17 , 18 , 19 , 20 Specifically, in large population-based studies in Sweden (including 26 986 autistic individuals) and Norway (including 7528 autistic individuals), autistic individuals were twice as likely to have substance use problems than non-autistic individuals; and even their non-autistic siblings and parents were at increased risk of substance use problems compared with controls, suggesting that genetic or environmental factors might contribute to risks.…”

Students with Autism Spectrum Disorders and Their First-Year College Experiences

“…These include situational factors such as physical health, employment, and family responsibilities, institutional factors such as policy, support programs, financial aid, and staff responsiveness, and dispositional factors such as self-confidence, attitudes, and beliefs [10,11]. Early identification of students at risk of dropping out during the first year of college can lead to early intervention actions such as tutoring, counseling, and mentoring, all of which prevent student withdrawal [12][13][14][15][16][17].…”

Autism and physical health across the lifespan

“…Risk for mental health concerns in children who have autism is high (Kerns et al, 2020) and does not abate in the transition years. Studies in this special issue showed that physical and mental health were worse in autistic college students than in neurotypical peers (McLeod et al, 2021). Autistic transition-age youth also showed the highest use of mental health services and psychotropic medications relative to neurotypical peers or peers with attention deficit hyperactivity disorder (ADHD) or with diabetes mellitus (Ames, Massolo, Davignon, Qian, and Croen, 2021).…”